California Is Still A Puzzle

The map above shows California's COVID status as of April 27, just two days ago. Most counties are now in the "orange" tier, and this covers nearly 90% of the state population. "Orange" restrictions are still stricter than in many other states, but they do allow most indoor activities at 50% capacity.

What's remarkable is how quickly conditions have improved. The map at right is from just a month ago, March 30, with far fewer counties in the "orange" tier, most still "red" and three in "purple". Over the course of just a month, most of the state changed from "red" to "orange", with the three worst cases leaving "purple, while two more became "yellow". At this point, it appears that over the course of May, most of the state will move to "yellow", though this will still be more restrictive than other states like Florida or Arizona.

But here's the continuing puzzle. I've already noted that Los Angeles County in particular has been very aggressive in locating vaccination sites in the poorest areas, but from the second map above, it's been unique in this. Earlier this year, once vaccine became available, the county was very quick to move from "purple" through "red" to "orange", but other counties like Fresno, with many poor residents but apparently not quite as aggressive, nevertheless followed LA County from "purple" to "orange", lagging by only weeks.

The fact is that, as the maps show, there have been no stubborn problem areas anywhere in the state. All the counties have been improving and making progress from tier to tier within weeks of each other. The maps are just snapshots.

LA County health department press releases, while carefully worded, have begun to indicate that even with aggressive efforts to make vaccine available in the poorest areas, uptake there hasn't been as expected.

The pandemic also disproportionately affected Non-White populations in the County. The impact on Pacific Islanders was particularly severe, with nearly 6 times as high a hospitalization rate as among White residents, and more than 3 times as high a death rate. Although Latino/Latinx residents were hospitalized at only 2.9 times as high a rate as White residents, they died from their infections at 3 times as high a rate. Black/African American (1.7), American Indian/Alaskan Native (1.6), and Asian (1.3) residents also died of COVID-19 at rates higher than those of White residents.

And,

The County has now vaccinated about half of Asian, White, and American Indian/Alaska Native residents in L.A. County and have also made some important gains in vaccinating multiracial community members, where vaccinations increased from 11% to 37% with one dose. In Latinx residents, the vaccinated proportion of the population increased more than fourfold of what it was two months ago, and in Black residents, the proportion increased more than threefold.

Despite all efforts, the impact has still been most severe on Latins. This is probably why the counties in the San Joaquin Valley have been slower (though by a matter of only weeks) to move from "red" to "orange", as they have a high proportion of poor agricultural workers, who are mostly Latin. In turn, the reason for this is that Latins are the group most likely not to have their immigration status in order, and vaccination does require that one register. Best not to do anything that could bring attention to themselves, clearly.

But then, with a certain substantial part of the population, which is the poorest and sickest, resisting vaccination, why is California otherwise doing so well, the best in the US and up there with the best in the world? I've got to think that, since all US states have received vaccines in the same proportion, and California counties have all been improving individually and apparently doing better than many US states, other factors besides just vaccines are involved.

But I don't think it's lockdowns. The most severe lockdowns in the country had no effect on the late 2020 surge in California. There must be another factor besides vaccines.